BACKGROUND:Successful uterine spiral artery remodeling is necessary for normal pregnancy,in which vascular smooth muscle cells are important cells.Interferon-γ is associated with the loss of vascular smooth muscle cells during early pregnancy.However,the specific mechanism is not fully understood. OBJECTIVE:To investigate the effects of interferon-γ on migration and apoptosis of vascular smooth muscle cells through NLRP3/caspase-1/GSDMD pyroptosis pathway. METHODS:Human vascular smooth muscle cells were divided into control group and interferon-γ group.The control group was cultured normally,and the interferon-γ group was treated with 10 ng/mL interferon-γ for 24 hours.The migration ability of vascular smooth muscle cells was detected by Transwell assay.The apoptosis of vascular smooth muscle cells was detected by TUNEL assay and flow cytometry.The mRNA expression levels of NLRP3 and caspase-1 were detected by qPCR.Western blot assay was utilized to detect NLRP3,caspase-1,and cleaved N-terminal GSDMD protein expression levels. RESULTS AND CONCLUSION:Compared with the control group,the migration ability and apoptosis rate of vascular smooth muscle cells in interferon-γ group were significantly increased(P<0.05).Compared with the control group,the mRNA expression levels of NLRP3 and caspase-1 in vascular smooth muscle cells of interferon-γ group were significantly increased(P<0.05).Compared with control group,the expression levels of NLRP3,caspase-1,and cleaved N-terminal GSDMD protein in vascular smooth muscle cells in the interferon-γ group were significantly increased(P<0.05).The results suggest that interferon-γ may regulate the migration and apoptosis of vascular smooth muscle cells through NLRP3/caspase-1/GSDMD pyroptosis pathway.

Objective To investigatethe relationship between gastroesophageal reflux disease (GERD) symptoms and clinicopathological characteristics, p53 expression, and survival of Chinese patients with esophageal adenocarcinoma. Methods A total of 3882 patients with esophageal adenocarcinoma, 970 matched patients with esophageal squamous cell carcinoma, and 970 matched patients with gastric cardia adenocarcinoma were included to compare the incidence of GERD symptoms. Patients with esophageal adenocarcinoma were divided into two groups according to the presence and absence of GERD symptoms. The differences in clinicopathological characteristics and p53 expression between the two groups were compared by chi-square test, and the differences in survival between the two groups were compared by landmark analysis. Results The incidence of GERD symptoms increased successively in esophageal squamous cell carcinoma, esophageal adenocarcinoma, and gastric cardia adenocarcinoma. In patients with esophageal adenocarcinoma, the proportions of male, less than 65 years old, lower thoracic tumors, tumors without squamous cell carcinoma, poorly differentiation, early tumors (stage 0-I), and p53-positive tumors in the group with GERD symptoms were higher than those in the group without GERD symptoms; moreover, the long-term survival (≥15 years) was better. Conclusion GERD symptom is an important clinical sign of esophageal adenocarcinoma. It is closely related to specific clinicopathological characteristics, p53 overexpression, and good long-term prognosis.

Abstract Enhancing the health literacy of the entire population is a prerequisite for improving the health of the entire population, and since the health attitudes and behaviors formed during childhood and adolescence have a profound impact on the health patterns of adulthood, the enhancement of health literacy of children and adolescents is of particular importance. As the main place for children and adolescents to receive education, schools should better fulfil the function of education and promotion of health literacy. China has been carrying out the pilot and promotion of health promoting schools (HPS) since 1995, and is currently in the stage of comprehensive improvement of HPS construction. This paper introduces the background and characteristics of Health-Literate Schools (HeLit-Schools) in foreign countries and compares them with HPS in China, drawing on the advantages of HeLit-Schools to provide a new idea and a new way of thinking for the construction of HPS in China and for the practice of the "Healthy China Initiative".

Objective To investigate the relationship between polymorphism of resistin(RETN)gene and metabolic associated fatty liver disease(MAFLD)in type 2 diabetes mellitus(T2DM)patients in middle and high altitude areas.Methods A total of 400 patients with T2DM in Qinghai area were recruited and divided into simple T2DM group(T2DM,n=200)and T2DM combined with MAFLD group(T2DM+ MAFLD,n=200)according to liver ultrasonography.Healthy individuals confirmed by physical examination were selected as the normal control group(NC,n=180).Plasma resistin levels were measured by ELISA.The polymorphism of RETN-420C/G and +299G/A genes were detected by PCR sequencing.Results By comparing the polymorphism of RETN-420C/G gene in each group,it was found that the frequencies of G/G genotype and G allele frequency in T2DM+MAFLD group were higher than those in NC group and T2DM group(P<0.05),while the frequencies of C/C genotype and C allele frequency were lower than those in NC group and T2DM group(P<0.05).The risk of MAFLD increased by 1.571,2.126 and 1.537 times respectively in T2DM patients with C/G,G/G genotype and G allele.Logistic regression analysis showed that G/G genotype was a risk factor for MAFLD in T2DM patients.By comparing the polymorphism of RETN+299G/A gene in each group,it was found that A allele frequency in T2DM+MAFLD group was higher than that in NC group and T2DM group,while G allele frequency was lower than that in NC group and T2DM group(P<0.05).The allele A increased the risk of MAFLD in T2DM patients by 1.432 times compared to allele G.Conclusion RETN gene-420C/G locus G/G genotype increases the risk of T2DM combined with MAFLD in middle and high altitudeareas.

In order to provide basic information for the utilization and development of famous classical formulas containing Bletillae Rhizoma， this article systematically analyzes the historical evolution of the name， origin， harvesting and processing of Bletillae Rhizoma by reviewing the ancient materia medica， prescription books， medical books and modern literature. The research results showed that Baiji（白及） was the main name， some scholars took Baiji（白芨） as its main name， and there were many other names such as Baiji（白给）， Baigen（白根）， Baiji（白苙）. The mainstream source of Bletillae Rhizoma was the tubers of Bletilla striata， and drying， large， white， solid， root-free and skin removed completely were the good quality standards. With the promotion of wild to cultivated medicinal materials， there were certain differences between their traits， and the quality evaluation indexes should be adjusted accordingly. The origin of records in the past dynasties was widely distributed， with Guizhou and Sichuan having high production and good quality in modern times. The harvesting period is mostly in spring and autumn， and harvested in autumn was better. The processing and processing technology is relatively simple， and it was used fresh or powdered in past dynasties， while it is mainly sliced for raw use in modern times. Based on the results， it is suggested that the tubers of Bletilla striata of Orchidaceae should be used in the famous classical formulas， and it should be uniformly written as Baiji（白及）. And if the original formula indicates the requirement of processing， it should be operated according to the requirement， if the requirement of processing is not indicated， it can be used in raw form as medicine.

Objective To analyze the changing trends of the incidence and onset age of cervical cancer in Jiangsu Province by using cancer registration data from 2009 to 2019. Methods The information of national cancer registries with continuous data from 2009 to 2019 was selected, and the quality control indices of cancer registration must be up to standards. A total of 16 registries were included in this study. Statistical analysis indicators include the crude incidence rate of cervical cancer, age-standardized incidence rate, actual average onset age, age-standardized average onset age, and average annual percentage change (AAPC). A birth cohort model was constructed to analyze the incidence of cervical cancer among women born from 2009 to 2019 and its incidence trend. Results From 2009 to 2019, the crude and age-standardized incidence rates of cervical cancer among women in Jiangsu Province showed upward trends, with AAPCs of 5.62% (95%CI: 3.47−7.82) and 4.14% (95%CI: 2.06−6.27), respectively. The incidence rate of cervical cancer in rural areas (AAPC=4.46, 95%CI: 1.13−7.91) increased more than that in urban areas (AAPC=3.83, 95%CI: 2.81−4.86). The actual average onset age of cervical cancer increased from 51.53 years in 2009 to 55.07 years in 2019 (β=0.36, P<0.05). The age-standardized average onset age increased from 48.89 years in 2009 to 50.43 years in 2019 (β=0.21, P<0.05). The age composition ratios of cervical cancer in the age group of 60 years and older were 31.90% in 2019 and 22.40% in 2009 (β=3.66, P<0.05). The incidence of cervical cancer in the same age group of people with different birth years showed an upward trend with the increase in birth year. Conclusion From 2009 to 2019, the incidence rate of cervical cancer in Jiangsu Province showed an upward trend, and this trend was more obvious in rural areas than in urban areas. In addition, the average onset age of cervical cancer showed an upward trend.

Objective To analyze the influencing factors of sarcopenia in patients with advanced lung cancer undergoing anti-tumor therapy,and to explore the adverse effects of sarcopenia on patients with ad-vanced lung cancer undergoing anti-tumor therapy.Methods Patients with advanced lung cancer who received anti-tumor therapy in the Department of Oncology of a tertiary hospital in Chengdu from January to December 2021 were continuously included.The incidence situation of sarcopenia in patients with advanced lung cancer undergoing anti-tumor therapy was evaluated by using the 12th thoracic spine (T12) skeletal muscle index (SMI) standard.According to the diagnostic criteria of sarcopenia,the patients were divided into the sarcope-nia group and the non-sarcopenia group.Multivariate logistic regression was used to analyze the influencing factors of sarcopenia in patients with advanced lung cancer undergoing anti-tumor therapy.Results A total of 285 patients were included in this study,of which 123 cases (43.15％) were diagnosed as sarcopenia.Multiva-riate analysis showed that gender (P<0.001),pathological stage (P=0.012),creatinine (P=0.031) and BMI (P<0.001) were the influencing factors of sarcopenia in patients with advanced lung cancer undergoing anti-tumor therapy.The quality of life score of patients in the sarcopenia group was significantly lower than that in the non-sarcopenia group (P=0.035).Conclusion The incidence of sarcopenia in patients with ad-vanced lung cancer undergoing anti-tumor therapy is high,which is related to many factors and affects the quality of life.

Purpose To investigate the clinicopathologic,immunophenotypic features,genetic alterations and prognosis of melanotic Xp11 neoplasms/melanotic TFE3-rearrangement neo-plasms.Methods Five cases were selected from the Depart-ment of Pathology,Union Hospital,Huazhong University of Sci-ence and Technology from November 2018 to July 2023.The clinicopathologic,immunohistochemical,FISH assays,next-generation sequencing(NGS)and follow-up details were collect-ed.Results There were 1 male and 4 females,with their ages ranging from 16 to 59 years(mean 28.2 years).The maximum diameters of the masses were 3-6 cm(average 4.7 cm).The tumors located in right kidneys(3 cases),tubal interstitium(1 case)and pelvis(1 case).Microscopically,most tumors shared similar morphology such as nested,acinar structures sep-arated by a delicate vascular network.Epithelioid tumor cells presented with clear to granular eosinophilic cytoplasm.Lym-phocytic infiltration was seen in the background;melanin depo-sition was noted in the cases;neoplastic necrosis was detected in 4 cases.Mitotic activity was low with 5 cases showing＜3/10 HPF.Intravascular tumor thrombus was detected in 2 cases,no lymphovascular and nerve invasions were detected in other 3 ca-ses.Immunohistochemically,all 5 cases expressed TFE3 dif-fusely,and expressed HMB45,Melan A to varying degrees,CK(AE1/AE3),CK7,EMA,PAX8,TFEB,S-100,SOX10,SMA,desmin were all non-reactive in the 5 cases.The Ki67-la-beling index was＜20％.TFE3 separation signal in 4 cases were detected by FISH,1 case was interpreted as negative due to atypical signal which was confirmed by next-generation se-quencing(NGS)assay as RBM10-TFE3.Clinical follow-up was available for five patients for 2-60 months,in which four pa-tients were alive with no evidence of disease after initial resec-tion,and one patient with thoracic spine metastasis was currently in stable condition.Conclusion Melanotic Xp1 1 neoplasms/melanotic TFE3-rearrangement neoplasms has unique morpholog-ic,immunophenotypic and genetic characteristics.It might be reclassified into a distinctive malignant mesenchymal tumor enti-ty.

Objective To investigate the clinical characteristics of 16 patients with connective tissue diseases associated interstitial lung disease(CTD-ILD)complicated with lung cancer,and to improve the cognition of the disease.Methods Clinical data of 16 patients diagnosed as CTD-ILD associated with lung cancer,who were admitted to our center,were retrospectively analyzed,including general conditions,clinical characteristics,auxiliary examinations,pathological classification of lung cancer,TNM type,treatment and clinical outcome.Results Among the 16 CTD-ILD patients with lung cancer,there were 12 males and 4 females.The mean age at diagnosis of CTD-ILD was(64.7±9.2)years,and the mean age at diagnosis of lung cancer was(66.6±8.7)years.Lung occupying space on imaging(62.5%)was the most common initial symptom in lung cancer patients,followed by cough and phlegm(12.5%)and chest pain(12.5%).Of patients with lung cancer,adenocarcinoma(8 cases,50.0%)was the most common pathological type,followed by small cell lung cancer(4 cases,25.0%).The diagnosis time of CTD-ILD was earlier than that of lung cancer in 8 cases(50.0%),with a median time of 36.0(11.3,57.0)months,followed by 7 cases(43.8%)of CTD-ILD diagnosed with lung cancer at the same time.The diagnosis time of lung cancer was earlier than that of CTD-ILD in 1 case(6.3%).The most common TNM stage for lung cancer was stage Ⅳ(9 cases,56.25%).Sixteen patients were followed up from 1 to 64 months,with a median of 8.5(1.5,14.3)months.Eleven patients(68.8%)died,including 8 patients(72.7%)died of infection and 3 patients(27.3%)died of end-stage lung cancer.Conclusion For CTD-ILD patients,close follow-up and regular imaging monitoring are necessary to help early detection of lung cancer and improve prognosis.

Objective:To explore the correlation between the initial estimated glomerular filtration rate (eGFR) and all-cause mortality in end-stage renal disease (ESRD) patients undergoing urgent-start peritoneal dialysis (USPD).Methods:The clinical data of 380 ESRD patients undergoing USPD from January 2013 to June 2023 in Affiliated Hospital of Jining Medical University were retrospective analyzed. According to the median initial eGFR of 6.25 ml/(min·1.73 m 2), the patients were divided into low eGFR group with eGFR<6.25 ml/(min·1.73 m 2) and high eGFR group with eGFR ≥6.25 ml/(min·1.73 m 2), with 190 patients in each group. The baseline characteristics and hematological indexes within 48 h before USPD were compared between the two groups. The patients were followed up until death or until June 30, 2023, and all-cause mortality was recorded. The Kaplan-Meier survival curve was used to evaluate the accumulated survival rate. Multivariate Cox regression analyses were used to identify the independent risk factors for all-cause mortality in ESRD patients undergoing USPD, with subgroup analyses based on age, gender and diabetes. Results:The median follow-up time was 40.7 (21.7, 59.0) months, 112 patients died, with a total mortality rate of 29.5% (112/380). The blood potassium, blood phosphorus, urea nitrogen, uric acid, parathyroid hormone and dialysis age in high eGFR group were significantly lower than those in low eGFR group: (4.1 ± 0.7) mmol/L vs. (4.5 ± 0.8) mmol/L, (1.6 ± 0.4) mmol/L vs. (1.9 ± 0.6) mmol/L, (21.8 ± 7.2) mmol/L vs. (29.7 ± 11.0) mmol/L, (359.8 ± 99.4) μmol/L vs. (429.4 ± 116.9) μmol/L, 242.2 (151.5, 398.3) ng/L vs. 281.7 (189.1, 487.2) ng/L and 36.1 (18.8, 54.0) months vs. 43.7 (28.8, 68.2) months, the diabetes rate, hemoglobin, platelet count, blood chloride, fasting blood glucose and mortality rate were significantly higher than those in low eGFR group: 20.0% (38/190) vs. 11.6% (22/190), (100.6 ± 18.2) g/L vs. (96.1 ± 20.0) g/L, (207.7 ± 72.6) × 10 9/L vs. (192.4 ± 65.6) × 10 9/L, (100.6 ± 4.1) mmol/L vs. (99.4 ± 4.7) mmol/L, (5.9 ± 2.3) mmol/L vs. (5.5 ± 1.9) mmol/L and 34.2% (65/190) vs. 24.7% (47/190), and there were statistical differences ( P<0.01 or< 0.05). Kaplan-Meier survival curve analysis result showed that the all-cause mortality rate in high eGFR group was significantly higher than that in low eGFR group, and there was statistical difference (log-rank χ2 = 6.64, P<0.01). After adjusting for gender, age and confounding factors, multivariate Cox regression analysis result showed that elevated eGFR, increased mean corpuscular volume and elevated fasting blood glucose were independent risk factors for all-cause mortality in ESRD patients undergoing USPD ( HR = 1.14, 1.04 and 1.15; 95% CI 1.04 to 1.26, 1.01 to 1.08 and 1.03 to 1.29; P<0.01 or<0.05), while female was an independent protective factor ( HR = 0.59, 95% CI 0.38 to 0.92, P<0.05). Subgroup analysis result showed a consistent effect of eGFR on mortality in ESRD patients undergoing USPD. Conclusions:Higher initial eGFR in ESRD patients undergoing USPD is associated with an increased risk of all-cause mortality.